血浆D-二聚体、抗凝血酶Ⅲ和血清超敏C反应蛋白联合检测诊断产妇深静脉血栓的价值

Applicability of joint detection of plasma D-dimer,antithrombinⅢ,and serum hypersensitive c-reactive protein in the diagnosis of deep vein thrombosis among postpartum females

目的 探讨血浆D-二聚体(D-D)、抗凝血酶Ⅲ(ATⅢ)与血清超敏C反应蛋白(hs-CRP)联合检测诊断产妇深静脉血栓(deep vein thrombosis,DVT)的价值。方法 选取2015-01至2018-12新疆军区总医院经MRI及B超检查确诊的60例DVT产妇为治疗组,另取健康产妇60例为对照组,检测治疗组治疗前、治疗后3、7 d的D-D、hs-CRP和ATⅢ水平,并与对照组进行比较,分析三项指标与DVT的相关性。结果 治疗组治疗前血浆中D-D、hs-CRP水平显著高于对照组产妇,在治疗后显著下降;ATⅢ水平显著低于对照组,在治疗后显著升高。D-D、hs-CRP与DVT疾病发生呈正相关(标准化回归系数分别为0. 182和0. 518),而ATⅢ与DVT发生呈负相关(标准化回归系数为-0. 222)。结论 D-D、hs-CRP和ATⅢ均参与了DVT的发生过程,三者的联合检测对早期诊断产妇产后发生DVT具有较高的灵敏度和特异度。D-D、hs-CRP、ATⅢ是产妇DVT预后不良的独立危险因素,可为血栓预后的判断提供一定的参考依据。

Objective To explore the clinical applicability of the joint detection of plasma D-dimer(D-D),antithrombinⅢ(ATⅢ),and serum hypersensitive c-reactive protein(hs-CRP)in the diagnosis of deep vein thrombosis(DVT)for postpartum females.Methods Sixty patients diagnosed with DVT using nuclear magnetic resonance(MRI)and B-ultrasound between January 2015 and December 2018 served as the experiment group,while another 60 cases of normal healthy females were selected as the control group.The levels of D-D,ATⅢ,and hs-CRP before treatment,three days and seven days after treatment were compared.The correlations between the three indicators and DVT were analyzed.Results The levels of D-D and hs-CRP in the plasma of females in the experiment group were significantly higher than those of the healthy control group before treatment,but they declined remarkably after treatment.The levels of ATⅢin the experiment group were significantly lower than those of the healthy control group before treatment,and they increased remarkably after treatment.Levels of D-D and hs-CRP were positively correlated with DVT(standardized regression coefficients were 0.182 and 0.518,respectively),whereas ATⅢwas negatively related(the standardized regression coefficient was-0.222).Conclusions D-D,hs-CRP and ATⅢare involved in the occurrence of DVT.The joint detection of these three indictors has high sensitivity and specificity for the early diagnosis of DVT for postpartum females.D-D,hs-CRP and ATⅢare independent risk factors for poor prognosis for postpartum patients with DVT,and they can be used as reference for prognostic detection of thromboses.